Department of Dermatology, Saint Eloi Hospital, Montpellier University, Montpellier, France.
Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.
Contact Dermatitis. 2018 Aug;79(2):76-80. doi: 10.1111/cod.12995. Epub 2018 Apr 10.
The frequency of allergic contact dermatitis caused by (meth)acrylates is increasing worldwide, and isobornyl acrylate (IBOA) has been identified as a culprit sensitizer in FreeStyle Libre, a medical device used by diabetic patients.
To report on 4 patients sensitized to IBOA contained in OmniPod, a new, tubeless insulin pump, and to describe the clinical and chemical analytical work-up.
Four patients with eczematous skin eruptions after using OmniPod, including 2 with previous adverse skin reactions to FreeStyle Libre, were patch tested with a baseline series and additional (meth)acrylates, including IBOA in several concentrations and/or vehicles. Gas chromatography-mass spectrometry (GC-MS) was used to identify the presence of IBOA in OmniPod.
All patients were shown to be sensitized to IBOA. GC-MS identified IBOA in OmniPod, with the highest concentrations being found in the unit itself and not in the adhesive patch.
The OmniPod tubeless insulin pump is another source of IBOA, and its use may lead to primary sensitization to this acrylate, or may provoke elicitation of allergic contact dermatitis in previously sensitized patients. Our cases highlight the need to obtain satisfactory cooperation from pharmaceutical companies involved in the manufacture of these widely used medical devices.
(甲基)丙烯酸酯引起的过敏性接触性皮炎的频率在全球范围内正在增加,异冰片丙烯酸酯(IBOA)已被确定为糖尿病患者使用的医疗设备 FreeStyle Libre 中的致敏原。
报告 4 名对 OmniPod(一种新型无管胰岛素泵)中所含 IBOA 产生过敏的患者,并描述其临床和化学分析评估。
对 4 名使用 OmniPod 后出现湿疹样皮疹的患者进行斑贴试验,包括 2 名之前对 FreeStyle Libre 有过不良皮肤反应的患者,使用基础系列和其他(甲基)丙烯酸酯进行斑贴试验,包括 IBOA 的几种浓度和/或载体。使用气相色谱-质谱法(GC-MS)来确定 OmniPod 中是否存在 IBOA。
所有患者均对 IBOA 产生过敏。GC-MS 鉴定出 OmniPod 中存在 IBOA,其最高浓度存在于设备本身,而不在粘贴片中。
无管胰岛素泵 OmniPod 是 IBOA 的另一个来源,其使用可能导致对这种丙烯酸酯的原发性致敏,或者可能在先前致敏的患者中引发过敏性接触性皮炎。我们的病例强调了有必要从参与制造这些广泛使用的医疗设备的制药公司获得满意的合作。